| Objective:To analyze the helper T cell 17(Th17)and regulatory T cells(Treg)and their related inflammatory factors,and to explore their clinical significance with the occurrence of Kawasaki disease and coronary artery injury.Methods:From January 2018 to December 2018,40 patients with Kawasaki disease in the hospital were selected as the acute phase of KD group.The acute phase was divided into coronary artery disease group(CALs)and non-coronary artery disease group(NCALs).Forty patients were examined as healthy controls.Peripheral venous blood was taken from the acute phase of the child’s disease and healthy controls.The percentage of helper T cells 17(Th17)and regulatory T cells(Treg)in peripheral blood was measured by flow cytometry and Th17 cells were calculated.The ratio of the percentage to the percentage of Treg cells,the serum of the acute and recovery period of children with Kawasaki disease,the serum of the healthy control group,and the IL-17,IL-10,IL-6 were measured by enzyme-linked immunosorbent assay(ELISA).The contents of TNF-αand TGF-βwere collected,and their basic clinical information was collected.The experimental data were analyzed by SPSS 21.0.Results:1.Comparison of clinical data of acute CALs group and NCALs group in KD group:PLT of the two groups was statistically significant(P<0.05).The percentage of Th17 cells and TH17/Treg in whole blood were statistically significant(P<0.05).the anti-inflammatory factors IL-10,TGF-β,the difference was statistically significant(P<0.05),the pro-inflammatory factor TNF-αdifference was statistically significant,the other clinical indicators were not statistically significant.2.Comparisons of basic data in acute phase of KD group:The age of onset of KD was mainly concentrated in people under 1 year old,only the proportion of coronary artery injury was significantly different from that of the other two groups.3.Comparison of acute CALs group and NCALs group in KD group:PLT,whole blood Th17 cell percentage and TH17/Treg anti-inflammatory factors IL-10,TGF-β,TNF-αwere statistically significant between the two groups(P<0.05),the differences in gender,PCT,ESR,CRP,IL-6,IL-17,and Treg cells between the two groups were not statistically significant(P>0.05).4.Comparison of serum cytokine concentrations in the acute and recovery phases of the KD group:IL-10,TGF-β,IL-6,IL-17,TNF-αin the acute and healthy groups of the KD group There was statistical significance(P<0.05).There was significant difference in the Expression of IL-8 in Kawasaki disease.proinflammatory factors IL-6,IL-17 and TNF-αbetween the acute phase and the recovery period of KD group.There was no statistically significant anti-inflammatory cytokine.Compared with the recovery period,the difference between the anti-inflammatory cytokines IL-10 and TGF-βwas statistically significant.5.Correlation analysis between the expression levels of Th17 and Treg in acute phase of KD and PCT,ESR,CRP and PLT:The expression level of Th17 in acute phase of KD was positively correlated with PCT,ESR and CRP,which was statistically significant(P<0.05);The expression level of Treg in acute phase of KD was negatively correlated with PCT,PLT and CRP,which was statistically significant(P<0.05).Correlation between IL-10,TGF-β,IL-6,IL-17,TNF-αlevels and degree of cardiovascular injury:results show that IL-10,TGF-β,TNF-αare associated with cardiovascular damage Among them,TGF-βwas negatively correlated,and TNF-αand IL-17 were positively correlated.6.Logistic regression analysis showed that the independent influencing factors of coronary artery lesions in KD patients were PLT,Th17,Treg,Th17/Treg,IL-6,TNF-α,and the POR had an OR value of 1.988,and the child’s PLT increased by 100 X10~9/L,the risk of coronary artery injury increased by 1.988 times,the OR value of Th17 was 1.977,and the risk of coronary artery injury increased by 1.977 times for each 1%increase in Th17,and the OR value of Treg was 0.610.For every 1%increase,the risk of coronary artery injury increased by 0.610 times,the OR value of Treg/Th17 was 1.874,and the risk of coronary artery injury increased by1.874 times for every 1%increase in Treg.The OR value of IL-6 was1.978.For every 1pg/mL increase in IL-6,the risk of coronary artery injury increased by 1.978 times,the OR value of TNF-αwas 1.877,and the TNF-αincreased by 1pg/mL.The risk of coronary artery injury increased by 1.877 times.7.Using the percentages of PCT,PLT,CRP,ESR and Th17,the percentages of Treg and the concentrations of Th17/Treg,IL-6 and TNF-alpha as variables,ROC curves were made.According to the principle of maximum Yoden index,the critical value of PLT in diagnosing CALs during the development of KD was determined to be476.28 X109/L,the sensitivity was 54.1%,and the specificity was 69.1%.According to the principle of maximum Yoden index,the critical value of Th17 in diagnosing CALs during the development of KD was determined to be 476.28 X109/L.6.99%,sensitivity 65.0%,specificity 97.5%.According to the principle of maximum Yoden index,the critical value,sensitivity 37.5%and specificity of Treg in diagnosing CALs during the development of KD were determined to be 8.40%,37.5%and 97.5%.According to the principle of maximum Yoden index,the critical value of Th17/Treg in diagnosing CALs during the development of KD was determined to be 1.90,sensitivity 77.5%,specificity 60.0%.It was confirmed by the principle of maximum Yoden index.The critical value of IL-6 was 32.11 pg/mL,the sensitivity was 56.7%,and the specificity was 90.0%.According to the principle of maximum Yoden index,the critical value of TNF-alpha for diagnosing CALs in the development of KD was 820.90 pg/mL,the sensitivity was 66.8%,and the specificity was89.0%.In summary,PLT,Treg and Th17/Treg are generally accurate in the diagnosis of CALs in the development of KD.Th17 and IL-6 have certain accuracy in the diagnosis of CALs in the development of KD.IL-6 and TNF-a have better accuracy in the diagnosis of CALs in the development of KD.Conclusions:1.The percentage of Th17 cells,the percentage of Treg cells,and Th17/Treg are associated with the development of Kawasaki disease.2.Th17 cells,Treg cells,Th17/Treg and related inflammatory factors have certain clinical value for the prediction and judgment of coronary artery injury. |
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